Healthcare Provider Details

I. General information

NPI: 1689701732
Provider Name (Legal Business Name): OLIVIA ESQUIBEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 S. HUDSON AVE., ROOM 30
PASADENA AR
91711
US

IV. Provider business mailing address

351 S HUDSON AVE RM 30
PASADENA CA
91101-3507
US

V. Phone/Fax

Practice location:
  • Phone: 626-568-4500
  • Fax: 626-578-1204
Mailing address:
  • Phone: 626-568-4500
  • Fax: 626-578-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number269133
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: